Concussion – Can Prevalence be Reduced?

Concussion is a disturbance in the brain’s normal activity and is the most common (and mild) form of traumatic brain injury (McInnes et al 2017). The use of protective equipment and having medical help on standby has been the advice with contact sports for many years, however over the last decade or so there has been an increase in studies as to whether strengthening the neck musculature can reduce the prevalence of concussions.

Dempsey, Fairchild and Appleby (2017) suggest that an increase in neck strength reduces the acceleration speed of the head during a tackle in rugby, thus reducing the speed and impact at which the brain is thrust back and forth. Interestingly, different planes of movement showed varying significance of results, for example accelerations in the coronal plane (the forward-backward movement) showed better results from neck strengthening than that of the sagittal plane (the side-side movement).

Eckner et al (2014) support the notion that neck strength reduces acceleration speed and thus concussion rates, but add that activation of the relevant neck muscles, pre-hit, contributes to the lessened likelihood of concussion also.

There is some argument against the above claims and a suggestion that there are no definitive results that strengthening the neck can reduce concussion rates (Turner, Geifer and Lesh, 2017). However, the studies used in this systematic review that suggest no effect showed no detriments to improving neck strength and one may now be considered outdated anyway. Although this suggests that further studies are required in order to confirm the clinical significance of neck strengthening in contact sports, such as rugby, it does also suggest that there aren’t any negative outcomes to improving neck strength.

Despite disagreements on to what extent neck strength may reduce the prevalence of concussions in contact sports, the basis of the results that concussions may be better controlled via modifiable, preventative measures of neck strengthening is a significant step to improving the safety of contact sports. Additionally, there’s no reason why results can’t be transferable and applicable to members of the general public should they encounter an unexpected situation whereby concussion could occur.

 

Dempsey, A. R., Fairchild, T. J. and Appleby, B. B. (2017), The Relationship Between Neck Strength and Head Accelerations in a Rugby Tackle. In F. Colloud, M. Domalain and T. Monnet (eds.). 33rd International Conference on Biomechanics in Sports, France, pp 346-349.

Eckner, J. T., Oh, Y. K., Joshi, M. S., Richardson, J. K. and Ashton-Miller, J. A. (2014). Effect of Neck Muscle Strength and Anticipatory Cervical Muscle Activation on the Kinematic Response of the Head to Impulsive Loads. American Journal of Sports Medicine, 42 (3), pp. 566-576.

McInnes, K., Friesen, C. L., MacKenzie, D. E., Westwood, D. A. and Boe, S. G. (2017). Mild Traumatic Brain Injury (mTBI) and Chronic Cognitive Impairment: A Scoping Review. PLoS One, 12 (4), pp. 1-19.

Turner, K., Geifer, K. and Lesh, S. (2017). A Systematic Review: Does Neck Strength Play a Role in the Prevention of Sports-Related Concussion? Journal of Orthopaedic and Sports Physical, 47 (1), pp. 219-220.

(Image taken from: http://newtonslawconcussions.weebly.com/guidelines.html)

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